Dr Brendan Dias

Key Points

A penile prosthesis is a device surgically placed inside the penis to treat erectile dysfunction when tablets and injections no longer work. Inflatable three-piece implants are the most common type, and satisfaction rates among patients and partners are among the highest of any ED treatment.

Penile implants are considered when erectile dysfunction does not respond to tablets (such as sildenafil or tadalafil), injections, or vacuum devices — or when these are unsuitable.
The two main types are the three-piece inflatable implant (most natural erection) and the malleable (semi-rigid) implant (simpler, easier to use).
Surgery takes about one hour under general or spinal anaesthetic, usually through a single small incision, with most patients staying one night in hospital.
The implant is entirely concealed inside the body — nothing is visible externally, and sensation, orgasm and ejaculation are generally unchanged.
Published studies consistently report patient and partner satisfaction rates above 90% for inflatable implants.
Infection is the most serious complication (around 1–3% with modern antibiotic-coated devices); mechanical failure may require revision after 10–15 years.

Written and clinically reviewed by Dr Brendan Dias

Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)

Last clinically reviewed: 13 August 2026

What is a penile prosthesis?

A penile prosthesis (penile implant) is a medical device placed entirely inside the body to allow a man with erectile dysfunction (ED) to achieve an erection firm enough for intercourse. It is a long-standing, well-proven treatment and is usually considered when simpler therapies — tablets, injections or vacuum erection devices — have failed, are not tolerated, or are unsuitable.

Who is a candidate?

Penile implant surgery may be appropriate for men with:

ED that has not responded to medications such as sildenafil (Viagra) or tadalafil (Cialis)
ED after prostate cancer surgery or radiotherapy, including after robotic radical prostatectomy
Peyronie's disease with significant curvature and ED
ED related to diabetes, vascular disease or spinal cord injury
Contraindications to, or unsatisfactory results from, penile injections or vacuum devices

Good candidates are medically fit for surgery, free of active urinary or skin infection, and have realistic expectations about what the implant does — it provides rigidity but does not increase length, restore lost length, or change desire.

Types of penile implant

Three-piece inflatable implant

The most commonly chosen device. Two cylinders sit inside the penis, a small pump sits in the scrotum, and a fluid reservoir sits behind the abdominal wall. Squeezing the pump moves fluid into the cylinders to create a firm, natural-feeling erection; pressing a release valve returns the penis to a soft, natural flaccid state. It offers the best rigidity and the most natural appearance in both states.

Malleable (semi-rigid) implant

Two bendable rods are placed inside the penis, keeping it firm at all times but able to be positioned up for intercourse or down for concealment. It is simpler to use — often preferred for men with limited hand dexterity — and involves less mechanism, but the penis is never fully flaccid.

The operation

Surgery is performed under general or spinal anaesthetic and usually takes about one hour. The implant is inserted through a single small incision — either just below the penis or at the junction of the penis and scrotum. Nothing remains visible externally. Most patients stay in hospital one night and go home with a catheter removed before discharge or shortly after. Antibiotics are given to reduce infection risk.

Recovery

First 1–2 weeks: swelling, bruising and soreness are normal; simple pain relief is usually sufficient.
2–4 weeks: most men return to desk work and light activity; avoid heavy lifting and straining.
4–6 weeks: the device is usually activated (cycled) at a follow-up visit, and sexual activity can typically resume once cleared.

Outcomes and satisfaction

Penile implants have among the highest satisfaction rates of any ED treatment, with published series consistently reporting satisfaction above 90% for both patients and partners. Sensation, orgasm and ejaculation are generally unaffected because the implant does not involve the skin or urethra.

Risks

The most significant risk is infection, occurring in roughly 1–3% of first-time implants with modern antibiotic-coated devices — higher in men with diabetes or revision surgery. Mechanical failure can occur over time; modern devices have good durability, but revision may be needed after 10–15 years. Other risks include erosion, bleeding and device malposition. These are discussed in detail at consultation.

Frequently asked questions

Will anyone be able to tell I have an implant?

No. All components are inside the body. With an inflatable implant the penis looks and feels natural in both the erect and flaccid states.

Is penile implant surgery covered by private health insurance?

Yes — penile prosthesis surgery is a recognised procedure with Medicare item numbers, and appropriate private hospital cover generally applies. Out-of-pocket costs are discussed before surgery; see the fees page for consultation costs.

How long does the implant last?

Modern inflatable implants are durable; the majority function well beyond 10 years. If the device eventually fails mechanically, it can be replaced in a revision operation.

Penile implant surgery in Melbourne

Dr Brendan Dias performs penile prosthesis surgery and can advise whether an implant is right for you. Learn more on the penile prosthesis page, call +61 (03) 9110 3828, or use the contact form.

Penile Prosthesis (Penile Implant) Surgery — What to Expect